The female urethra is a fibromuscular tube that lies within the periurethral and endopelvic fascia. It is suspended between the tendinous arc of the obturator muscles. Urethral diverticula (UDs) arise from the periurethral glands and tend to present at the age of 30–60 years as an anterior vaginal lump with or without pain, dyspareunia, or voiding symptoms. Surgical management can be achieved with excision and reconstruction or, less commonly, marsupialization. Complications include stress urinary incontinence (SUI), urethrovaginal fistula, urethral stricture, and recurrence of diverticulum. Malignancy within a diverticulum is rare. Special care must be taken when excising urethral diverticula in patients with concomitant stress urinary incontinence.